Methotrexate Tablet Dosage Guide in Pakistan

There is one life-saving rule in Methotrexate dosing: for RA and psoriasis the dose is taken WEEKLY — NOT DAILY. This guide covers dosing, monitoring, and warnings. Always follow your doctor's instructions.

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-06-17

Dosage Guide

Quick Answer

Methotrexate is taken WEEKLY for RA and psoriasis. Folic acid 5mg must be co-prescribed on a separate day. Regular CBC, LFTs, and creatinine monitoring are required. The dose is always set by the doctor — self-dosing is absolutely forbidden.

Dose at a Glance

Adult Dose

As prescribed by your doctor (WEEKLY for RA/psoriasis — e.g. 7.5mg–25mg once weekly)

Once WEEKLY — one fixed day per week

Max: As directed by doctor — generally not more than 25mg/week for RA

Child Dose (Paediatric use — specialist only)

Under specialist supervision — paediatric rheumatologist only

As directed by specialist

Missed Dose

If you miss the weekly dose, take it as soon as you remember within that week. Return to the normal schedule the following week. NEVER TAKE A DOUBLE DOSE — this is dangerous.

Overdose

Methotrexate overdose is very serious — contact a doctor or emergency room immediately. Leucovorin (folinic acid) is the antidote — given only in a hospital setting.

Methotrexate Tablet Dosage (Kitni leni hai)

> LIFE-SAVING WARNING: Methotrexate for RA and psoriasis is taken WEEKLY — NOT DAILY. Daily dosing can cause serious toxicity and death. Confirm "weekly" in writing on the prescription.

Adult Dose (Baalgon ke liye)

As prescribed by your doctor
RA/Psoriasis: WEEKLY dose — one fixed day per week (e.g., every Saturday)
Starting dose: As directed by doctor (e.g., 7.5mg once weekly)
Usual dose: As directed by doctor (commonly 10mg–25mg once weekly for RA)
Choose one fixed day each week — as directed by your doctor

Starting Dose: As directed by doctor (commonly 7.5mg–10mg once weekly for RA)

Usual Dose: As directed by doctor (adjusted based on response and tolerance)

Max Weekly Dose: As directed by doctor — generally 25mg/week for RA

Folic Acid Co-prescription (Zaroori)

Folic acid 5mg must be taken weekly on a SEPARATE day from Methotrexate
Never take both on the same day — it can reduce effectiveness
This reduces side effects (mouth ulcers, nausea)

Monitoring Requirements (Regular Tests Zaroori)

CBC (Complete Blood Count) — bone marrow suppression check
LFTs (Liver Function Tests) — hepatotoxicity monitor
Creatinine / kidney function tests
Always follow your doctor's monitoring schedule

Child Dose (Bachon ke liye)

Under paediatric rheumatologist or specialist supervision — do not decide the dose yourself.

How to Take (Kaise lena hai)

Once WEEKLY — one fixed day per week
Same day every week — choose one fixed day
Taking after food is better — reduces nausea
Folic acid on a SEPARATE day

Missed Dose (Dose chhoot jaye to kya karein)

If you miss the weekly dose, take it as soon as you remember within that week. Return to the normal schedule the following week. NEVER TAKE A DOUBLE DOSE.

Overdose (Zyada Dose)

Methotrexate overdose is life-threatening. Contact the emergency room immediately. The antidote (Leucovorin) is only available in a hospital setting.

Dose Summary Table

Patient	Dose	Frequency	Notes
Adult (RA)	As directed by doctor	WEEKLY (not daily)	Folic acid on a separate day
Adult (Psoriasis)	As directed by doctor	WEEKLY (not daily)	Monitoring required
Child	Specialist only	Specialist decides	Paediatric rheumatologist

The information in this guide is for educational purposes only. Always confirm the dose with your doctor or pharmacist.

Frequently Asked Questions

Methotrexate roz kyun nahi lete?

Methotrexate is given WEEKLY for RA and psoriasis — daily dosing is a fatal medication error that can cause serious toxicity and death. Confirm the dose schedule in writing with your doctor.

Methotrexate ke sath folic acid kyun leni hoti hai?

Folic acid 5mg weekly (on a SEPARATE day from Methotrexate) is co-prescribed because Methotrexate blocks folate metabolism — folic acid reduces side effects (mouth ulcers, nausea).

Methotrexate ke sath kaunse tests zaroori hain?

CBC (Complete Blood Count), LFTs (Liver Function Tests), and creatinine should be monitored regularly. Always follow your doctor's monitoring schedule.

Kya Methotrexate ka dose khud se adjust kar sakte hain?

Absolutely not — only a rheumatologist or specialist adjusts the Methotrexate dose. Increasing or decreasing the dose on your own is dangerous.

Methotrexate kitni der mein kaam karna shuru karta hai?

The full DMARD effect of Methotrexate in RA becomes apparent after 6-12 weeks. Regular follow-up and monitoring are still required throughout.

Brand alternatives, same-class options, and other medicines used for the same conditions as Methotrexate Tablet.

Used for the same conditions

Other medicines commonly used for joint pain and overlapping conditions.

Joint Pain hub →

Sources

DRAP Registered Products Database — Drug Regulatory Authority of Pakistan
WHO Model List of Essential Medicines, 23rd ed. (2023) — World Health Organization
British National Formulary (BNF) — BMJ Group & Pharmaceutical Press

Medical disclaimer

This page is for educational use only and does not replace professional medical advice. Always confirm diagnosis, dose, and interactions with a qualified doctor or pharmacist before starting or changing any medicine.